Chief medical examiner sees role as 'voice for voiceless'

Dr. Kanthi de Alwis acts as teacher, grief counselor and scientist in her case work

That's what caught the attention of Dr. Kanthi de Alwis as she examined the body of a woman on the stainless steel slab at the morgue.

The woman, in her early 80s, had been brought in as an "unattended death," meaning simply that no doctor was present at the time of death. Typically, when the deceased is over 65 and there is no sign of trauma, no suspicious circumstances and the scene of death is undisturbed, the medical examiner will order a toxicology test and leave it at that. No full autopsy.

But this woman's hair was white or gray.

"You know how you see something and listen to that inner voice?"

With a forceps, she picked the black hair off the body. It wasn't the woman's.

"Then, when I looked at her neck, there was a very, very faint mark," recalls de Alwis. "And I decided I was going to open up" -- that is, perform a complete examination.

What she found was evidence of strangulation. Suddenly, de Alwis had a murder case on her hands -- a case that remains unsolved and one of the many that haunt her in her sixth year as Honolulu's chief medical examiner.

That's because de Alwis considers herself a staunch advocate for dead people, a courtroom "voice for the voiceless," as she puts it.

Part teacher, part scientist, part grief counselor, she has been called a "voodoo woman" in open court by one lawyer, but even attorneys at odds with her conclusions admit she's a straight shooter.

"She knows how to testify," says Earle Partington, a Honolulu defense lawyer. "There are some witnesses who are called by the state who think you are the enemy. She doesn't."

Kevin Takata, sounding more like a Hollywood agent than a deputy prosecutor, remarks: "When she testifies, she is a star. Jurors are captivated by her testimony. It is clear, concise and riveting. I have been prosecuting homicide cases for more than 17 years and in my opinion she is the premier medical examiner."

Her calling has not come without an emotional cost. De Alwis still remembers the heart-breaking injuries inflicted on Maile Gilbert, 6, kidnapped from a party at her parents' house in Kailua in 1985. Her body was later found in a shallow grave on the North Shore. The case led to the so-called Maile Alert system for abducted children, comparable to the Amber Alert system on the mainland.

"Certain deaths will never go out of my mind," de Alwis said in a recent interview. "I can close my eyes today and still remember all the injuries that Maile sustained. And I wanted to put closure to that case, so I met her parents a few months ago, and that was very healing for me because Maile was one of my first murder cases involving a child."

THE WORLD of violent death and grieving families is a far cry from her own childhood years as part of a well-to-do family in Ceylon, the Indian Ocean island known since 1972 as Sri Lanka. There, a maid helped her dress before she was driven by chauffeur 35 or 40 miles to a girls school in the capital, Colombo.

One of her early mentors was the "medicine man" in her village of Bandaragama.

"He was not a doctor," she recalls. "He was an older man who was our gardener. He would make herbal medicine. I would watch him and he would tell me stories. What he taught me was compassion."

De Alwis graduated from the University of Sri Lanka medical school in 1976 and came to Hawaii with her then-husband, a graduate student at the University of Hawaii, in 1979. Because Sri Lanka was attempting to stop a "brain drain," the couple was forced to leave behind everything but $50 in cash. To supplement their $190 monthly UH stipend, the newly minted physician worked at a shop in the International Market Place.

"I remember sitting in that shop," she recalled. "And pushing a wheelbarrow filled with clothes. I had tears in my eyes as to, did I really do the right thing by following my husband?"

They had also left their son, then 9 months old, behind in Sri Lanka with her family. The pressures of work and school would have left no time for his proper care; de Alwis missed him intensely.

FOREIGN MEDICAL STUDENTS wishing to further their studies in the United States had to take a special exam, and de Alwis put all of her energy into passing it. Then she faced a crossroads. If she were to pursue her first love, obstetrics-gynecology, it would be years, conceivably, before she could send for her boy.

Or, she thought, "do I switch to a field that will allow me to have my profession, to have some flexibility during the nights, where my husband can get his degree and I can get my son back? So, actually, as difficult as it was, I gave up OB and went into a pathology residency program with the John A. Burns School of Medicine."

De Alwis joined the medical examiner's office in 1984 as an anatomical/clinical pathologist and became first deputy medical examiner in late 1990. In her 22 years with the office, she estimates she has done close to 7,000 autopsies.

Formerly known as Kanthi von Guenthner, she retook her maiden name, de Alwis, after a painful divorce. She takes great pride in two grown sons, one of them an investment analyst in California, the other an obstetrician.

"What's so ironic is, my son who is 28 is in his second year in OBGYN. It's nice in a way that he got into the same field that I gave up on his behalf.

"But, you know, I have absolutely no regrets."

ONE OF HER FIRST tasks as chief medical examiner in 2001 was identifying the victims of the Ehime Maru, a Japanese boat sunk in a collision with a Navy submarine south of Oahu. For that effort, she received a citation for outstanding performance from Adm. Thomas Fargo, then commander in chief of the U.S. Pacific Fleet.

Now 53, she holds board certifications in both forensic pathology and anatomical/clinical pathology as she heads a team of three physicians, eight field investigators, two autopsy assistants, two lab specialists and three clerical secretaries. With a $1.4 million annual budget, the office handles about 1,900 cases a year, up from 1,200 a year in the 1980s.

A team or ohana approach is vital as the staff deals with the grimmer aspects of mortality: "Reading suicide notes, dealing with decomposing bodies filled with maggots, grieving relatives. ... If we don't have a nurturing, supporting environment with a sense of family," says de Alwis, "how can we continue to do this day in and day out?"

What has never gotten easier over the years is dealing with family members of someone who has just died a violent death, she says.

"My philosophy is that we have to have open doors here. Why? A family cannot go through the grieving process if they have unanswered questions."

That said, efforts are made to spare the family as much shock as possible.

"What we do is show them a picture of the face on our computer," says de Alwis. "But if the family insists that they want to see the actual person after seeing the picture, we make exceptions on a case by case basis if there are not too many injuries. We explain if there are too many injuries that you may not want to remember him or her that way."

One of her more jolting experiences involved a woman killed in an auto accident.

"In this case, the father brought in four children. The youngest was only a few months old and the oldest was 8. And the father lost it. He just left the children. There was another adult. And he just lost it. He screamed and cried and he left the kids. The kids were outside and I told myself, 'I am not a doctor any more. I am a mother.' The older kid was saying things like: 'I loved my mother. I wish I had listened to her and had done my homework.' God, we cried so much.

"And that we carry home."

THE GOOD NEWS is that modern technology is allowing a new look at many old unsolved murder cases.

Thanks to de Alwis' hunch about the stray black hair, police continue to pursue leads in the case of Edith Skinner, 81, found dead at Kalakaua Homes in 1989. Witnesses said they saw a man leaving her unit at about 5 that morning.

"It's one of those cases," says de Alwis, "that I still hope will be solved one day."